Why scruffy cartoons could solve your exam stress

Students often worry about how they will “learn” all the scientific articles that they have read so that they can use them in their exam. So many studies, so many details, so little time to cram them into your brain. I’m going to share a technique with you today that gives a purpose to your reading, develops your understanding, and helps you condense complex studies down into memorable chunks. I use this with the students on my final year module throughout the course, but you can start during revision too.

I want you to pick a paper that you want to know about for your exam. Now, grab some scrap paper, because we are going to try to represent the key methods and results of the paper as a diagram with as little writing as possible. The best place to start is the abstract, to get an overview, but pretty soon you’re going to have to dive into the method section to really figure out what they did in this study. Can you represent the method as a timeline? A flowchart? How can you represent what type of participants they are in a way you’ll remember? This will probably take a few different scribbled attempts, and lots of reading and rereading the method to be sure of what they did – that’s good, because all this time you’re developing and clarifying your understanding. Try to do this on a small piece of paper, maybe the size of an index card, so that you can’t make it too elaborate. Once you think you’ve got something accurate, have another look – double check it against the paper, and have a think about whether there’s anything you can eliminate (e.g. You don’t need to include “informed consent” as a stage – all your studies should have that, so let’s not worry about putting it in your summary). Remember here that there are no points for artwork, just for clarity. You should be able to redraw the diagram in 30 seconds or so, so don’t worry if it’s scruffy!

Once you have a method you’re happy with, could you represent the results on here too? Or add a redrawn graph that summarises the key findings? In fact, have you decided which are the key findings and why? Figure this out by reading the paper some more, and then add the most important finding to your diagram. If you HAVE to, this could be a statement, but better to put it in a picture as well if you can.

Finally, do you have any criticisms of the paper? Any cautionary notes? Things that the reader should be aware of? Again, you’ll need to have a read through the paper, and perhaps your lecture notes, and think about what these might be. You can now note this below the diagram, so that you can be critical of the paper if you talk about it in the exam.

Here’s an example of one I scribbled about a great paper by Erica Sloan who I am visiting at the moment in Australia.

If you look at the top two lines, you can admire my amazing pictures of mice, and see that the mice were subject either to restraint stress (the cage!) or left as controls. All mice were injected with tumour cells that were labelled to glow so that you can see where they go in the animal. At the end, the mice all had the same size primary tumour (the big blue dot) but the tumour had spread (metastasised) more in the restrained mice (more small blue dots) than the controls. The next two rows look at mechanisms – the pink cross is a beta blocker, which blocks the effects of stress hormones, and the green tick is a beta agonist which mimics the effects of stress hormones. You can see that the beta blocker blocks the effect of restraint on metastases, and the beta agonist replicates the effect of restraint stress even though these mice weren’t restrained. This is good evidence that the stress hormones are a mechanism enhancing the spread of cancer. At the bottom you’ll see I’ve drawn a little character representing a macrophage. Now, this is a reminder, that if I can remember the details, Erica also showed that macrophages are a potential mechanism underpinning all this – but that’s more complicated, and I wanted to get the basic design clear in my head first. You can do that too – layer up the findings so that when the basic design is clear, you can add more details. My cautionary note here is at the bottom – we have to remember that this is in mice and hasn’t yet been demonstrated in humans. However, as I note, there is some epidemiological evidence that beta-blockers are associated with reduced cancer progression.

So you’ll see, it’s not a great work of art, but it’s a pretty memorable summary of a great piece of science and once I had this, it was pretty easy to write the paragraph above describing the work. Importantly, I learned more about the work by trying to distill it down like this too. As you go through studies doing this, you’ll develop your own short hand – so in my field of stress and exercise immunology, you may always draw certain immune cells in particular ways, or use particular colours for older participants or younger adults. All the time, this is making it more clear, understandable, and memorable. Remember though, this isn’t just rote learning. It’s important that as you do this, you’re picking out the most important parts, and thinking about why do you want to talk about this study anyway (What was it first to do? Why is it particularly strong).

If you draw these on separate index cards, you can also shuffle them around to see how they fit together – for example, I might group Erica’s work with some human studies looking at whether self reported stress predicts cancer incidence (it tends not to) or cancer progression (more evidence of this). That’s what you’ll then do in the exam – shuffle through your mental notes of diagram summaries, and select those which will help you answer the question. You could even quickly scribble relevant diagrams down in the exam for your own reference, and then just write it out as study descriptions to evidence your points in your answer.

This technique is great to use in conjunction on my piece on revising without notes – you can see how much of the diagram you can draw from memory when you’re just sat on a bus or waiting for a friend in the coffeeshop. Good luck with trying it – I’d love to hear how you get on!